AAP Outlines Best Evidence Consensus for CBCT Usage

Dentistry Today


The American Academy of Periodontology (AAP) has published its first “best evidence consensus” (BEC) on CBCT. The proceedings are the result of the AAP’s inaugural BEC meeting in Chicago in February. The AAP developed the BEC model to address emerging clinical topics in periodontology for which there is insufficient evidence to arrive at definitive conclusions. Using current literature and expert opinion, the BEC model aims to provide clinicians with reasonable applications of newer technologies such as CBCT.

“As new technologies emerge, it often takes many years for sufficient high-quality evidence to allow clinicians to appropriately incorporate the technology into patient care,” said Kenneth Kornman, DDS, PhD, editor of the Journal of Periodontology. “The BEC reports are designed to bridge the gaps and provide evidence summaries and expert interpretations that guide clinical use now. We anticipate that the BEC reports will help us apply new technologies in a focused manner to help improve the health of our patients.”

Periodontists use CBCT in diagnosis, treatment planning, and surgical management, especially in patients with complex cases. Its 3-D nature offers enhanced diagnostic information and increased accuracy compared to 2-D imaging. While CBCT’s long-term radiation effects are unknown, adherence to the “as low as reasonably achievable” dosage standard, cautious shielding of susceptible tissues, and limitation of the field of view enable dental professionals to limit the risk of exposure.

The BEC proceedings, which will appear in the October issue of the Journal of Periodontology, include a statement that answers focused questions about CBCT’s use in specific clinical scenarios, such as the surgical management of patients requiring dental implants, determining the risk to periodontal structures in patients requiring periodontal-orthodontic treatment, and adding clinical value to diagnostic assessment and treatment planning in managing patients with periodontitis.  

The panel of more than 10 periodontists who participated in the BEC meeting determined that CBCT has diverse applications for both dental implant therapy and periodontal-orthodontic therapy and should be used when the benefit to the patient outweighs the risk. Its use in these dental cases can assist in planning a safer approach to treatment and facilitate interdisciplinary communication. While 2-D full-mouth radiographs are the gold standard for patients with periodontitis, CBCT may be beneficial in certain advanced cases.

“As the esteemed panel of periodontal experts who participated in the best evidence consensus meeting concluded, CBCT can serve as a useful and widely available tool that may improve patient care,” said Steven Daniel, DDS, president of the AAP. “Its utility in streamlining treatment planning and enhancing the periodontist’s specialized surgical and anatomical skills may allow for more predictable patient outcomes, especially in complex cases.”

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